Antibacterial Drugs that Interfere with Protein Synthesis

Question 1

adjunctive treatment

Answer 1

therapy used in addition to the primary treatment

Question 2

blood dyscrasias

Answer 2

abnormality of blood cell structure

Question 3

bowel preparation

Answer 3

treatment protocol to cleanse the bowel of bacteria before surgery or other procedures; also known as bowel prep

Question 4

circumoral

Answer 4

encircling the mouth

Question 5

enteric coated

Answer 5

special coating on drug that prevents absorption until drug reaches the small bowel

Question 6

Helicobacter pylori

Answer 6

stomach bacterium that causes peptic ulcer; also known as H. pylori

Question 7

hematuria

Answer 7

blood in the urine

Question 8

hepatic coma

Answer 8

coma induced by liver disease

Question 9

nephrotoxicity

Answer 9

damage to the kidneys by a toxic substance

Question 10

neuromuscular blockade

Answer 10

acute muscle paralysis and apnea

Question 11

neurotoxicity

Answer 11

damage to the nervous system by a toxic substance

Question 12

ototoxicity

Answer 12

damage to the organs of hearing by a toxic substance

Question 13

phenylketonuria (PKU)

Answer 13

a genetic birth defect causing the amino acid phenylalanine to build up to toxic levels in the body

Question 14

proteinuria

Answer 14

protein in the urine

Question 15

tinnitus

Answer 15

ringing or buzzing sound in the ears

Question 16

vancomycin resistant Enterococcus faecium (VREF)

Answer 16

bacteria resistant to the drug vancomycin

Question 17

Tetracyclines

Answer 17

a group of antibacterial drugs composed of natural and semisynthetic compounds. They are useful in select infections when the organism shows sensitivity to the tetracyclines, such as E. coli, gonorrhea, respiratory, and skin and skin structure infections caused by Staphylococcus aureus.

Question 18

Tetracyclines are useful when a client is allergic to:

Answer 18

penicillins or cephalosporins

Question 19

Tetracyclines are ________________ and exert their effect by _________________________.

Answer 19

bacteriostatic; inhibiting bacterial protein synthesis—process necessary for reproduction of the microorganism.

Question 20

Tigecycline (Tygacil) is the first drug in the:

Answer 20

glycylcycline class of tetracycline-like drugs that is more bacteria resistant.

Question 21

Tetracyclines are used to treat the following infections:

Answer 21

E. coli infections
Respiratory infections
Rickettsia diseases
Intestinal amebiasis
Some skin and soft tissue infections
Uncomplicated urethral, endocervical, or rectal infections caused by Chlamydia trachomatis
Severe acne as an adjunctive treatment
Infection with Helicobacter pylori in combination with metronidazole and bismuth subsalicylate

Question 22

Gastrointestinal system reactions of Tetracyclines

Answer 22

nausea or vomiting
diarrhea
epigastric distress
stomatitis
sore throat

Question 23

Other reactions of Tetracyclines

Answer 23

skin rashes
photosensitivity reaction

Question 24

What tetracycline seems to cause the most photosensitivity? Which seems to cause the least?

Answer 24

demeclocycline; minocycline

Question 25

Tetracycline is contraindicated:

Answer 25

in the client known to be hypersensitive to any tetracyclines; during pregnancy, because of the possibility of toxic effects to the developing fetus (Pregnancy Category D); during lactation; and in children younger than 9 years.

Question 26

Why are tetracyclines contraindicated in children younger than 9 years?

Answer 26

Because these drugs may cause permanent yellow-gray-brown discoloration of the teeth.

Question 27

Prolonged/repeated tetracycline therapy may result in:

Answer 27

overgrowth of non-susceptible bacterial or fungal organisms

Question 28

Tetracyclines should be used cautiously in clients with:

Answer 28

impaired renal function and those with liver impairment

Question 29

When degradation of the tetracyclines occur:

Answer 29

the agents are highly toxic to the kidneys

Question 30

Doses greater than 2 g/day:

Answer 30

can be extremely damaging to the liver

Question 31

Tetracycline interaction with antacids (containing aluminum, zinc, magnesium, or bismuth salts)

Answer 31

decreased effectiveness of tetracyclines

Question 32

Tetracycline interaction oral anticoagulants

Answer 32

increase risk for bleeding

Question 33

Tetracycline interaction with oral contraceptives

Answer 33

decreased effectiveness of contraceptive agent (breakthrough bleeding or pregnancy)

Question 34

Tetracycline interaction with digoxin

Answer 34

increased risk for digitalis toxicity

Question 35

Aminoglycosides primarily act against gram-________ bacilli and partially against gram-___________ bacilli.

Answer 35

negative; positive.

Question 36

Aminoglycosides may easily produce:

Answer 36

toxic reactions

Question 37

The aminoglycosides exert their bactericidal effect by:

Answer 37

blocking the ribosome from reading the mRNA, one of the steps in protein synthesis necessary for bacterial multiplication.

Question 38

Aminoglycosides may be used to reduce normal flora in the bowel when:

Answer 38

clients are having abdominal surgery or when a client is in a hepatic coma.

Question 39

neomycin is used before surgery to:

Answer 39

reduce intestinal bacteria; thought to reduce the possibility of abdominal infection that may occur after surgery on the bowel. This drug treatment protocol is referred to as a portion of the surgical bowel preparation.

Question 40

Use of neomycin and paromomycin

Answer 40

Used orally in the management of hepatic coma. In this disorder, liver failure results in an elevation of blood ammonia levels. By reducing the number of ammonia-forming bacteria in the intestines, blood ammonia levels may be lowered, thereby temporarily reducing some of the symptoms associated with this disorder.

Question 41

Aminoglycoside general system reactions

Answer 41

nausea
vomiting
anorexia
rash
urticaria

Question 42

Aminoglycosides; more serious adverse reactions may lead to discontinuation of the drug.

Answer 42

nephrotoxicity
ototoxicity
neurotoxicity

These toxicities are more likely to occur if the client has impaired renal function.

Question 43

nephrotoxicity signs and symptoms

Answer 43

proteinuria
hematuria
increase in blood urea nitrogen level
decrease in urine output
increase in the serum creatinine concentration

Nephrotoxicity is usually reversible once the drug is discontinued.

Question 44

ototoxicity signs and symptoms

Answer 44

tinnitus
dizziness
roaring in the ears
vertigo
mild to severe loss of hearing

If hearing loss occurs, it is usually permanent.

The short-term administration of neomycin as a preparation for bowel surgery rarely causes ototoxicity or nephrotoxicity.

Question 45

neurotoxicity signs and symptoms

Answer 45

numbness
skin tingling
circumoral paresthesia
peripheral paresthesia
tremors
muscle twitching
convulsions
muscle weakness
neuromuscular blockade

Question 46

The administration of the aminoglycosides may result in a:

Answer 46

hypersensitivity reaction, which can range from mild to severe and, in some cases, be life-threatening.

Mild hypersensitivity reactions may require only discontinuing of the drug, whereas the more serious reactions require immediate treatment.

Question 47

Aminoglycoside contraindications

Answer 47

in clients with hypersensitivity to aminoglycosides, preexisting hearing loss, myasthenia gravis, and Parkinson disease. During lactation or pregnancy (Pregnancy Category C, except for neomycin, amikacin, gentamicin, and tobramycin, which are in Pregnancy Category D). Also in long-term therapy, because of the potential for ototoxicity and nephrotoxicity.